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Illustration #� Ver�ion 10�: 1VIa� 2009 <br /> (Vew Construction Energy Code Cornpliance Certificate - <br /> �;;,; <br /> Per NI 101.8 Buildin�Ceriifieate.A building certificate shall Ue posted in a pennanently visible location inside the building• �� BUILDERS <br /> "I'he certificate sha11 be completed hy the builder and shall list inCormation and values of componenu�isted in Table N I 101.R. '= ��CIATIONOFMINNESOTA <br /> For deivled inFonn;ition on how to coircedy canplete this i'orm go to um�ieG��mn.org/energycnde DerelopcJ fi}•�hel3nrlde�trAa.srcinlian�f,tlrn»esoia <br /> for iu•e 1 y 1he residen(ird can.s�nrcti�n iixl�sny. <br /> --�15--�R_�-�—R�v�E _���---------------- --l��a�n ---___----- ---------------- <br /> Mailing Addrzss of Dwellino or Dwelling Unit City Date Ceitificate Posted <br /> C HA�lZ L�ES C u0b !�E /�o I/D ZOCo 3 S Z�-S <br /> Name of Residential Conu•actor MN License Number <br /> THERMAL ENVElOPE RADON SYSTEM <br /> Type:Check All That Apply P3ssi�c(No Pa�i) <br /> -' C Actitie(\�th fan and m6nometer o�other <br /> �a <br /> � o �,system monitoring devicc) <br /> a <br /> `^� yG u <br /> o C <br /> L <br /> � L � <br /> U " <br /> • � i� <br /> r. � o V <br /> d u a ,y <br /> � <br /> � E P] � u p ' � e <br /> � o y � � � � � :. <br /> z � � ' <br /> � v o ` � � <br /> .-� � bD C�`D ,G, U 7 7 <br /> � o a ' � � � �an Sn <br /> lnsulation Loeation �° z �+ w � r. z � � Othe,PlcaseDescriUcHerc <br /> I3eloir Gntire Slab' -p . �.� <br /> Foundation Wall Ciirle Loculio�r.(nleria•/F..steriorLLrtegral 5' <br /> Pcrimctcr of Slab on Crado r � _ <br /> Rim doist(Fnundutinn)Circ(e Localio :Lneria/ rerioi/Lategra! �s <br /> 12imJoiet(IstFlnar+)CvcleLocario : i�ierior c1e'rioi/LilegraT i� . � <br /> �Vall � <br /> Ccilin�g�Itat = - -- -.'�„j�. .. � <br /> Ceiling,vaulted 4¢ ✓ <br /> 6ny rvindo�rs or othcr cantilcyercd arcas�. � �p�� ��' � - <br /> -: ���. . ��< � ��. �7•LJ��; .� . _�- � .�..: <br /> 13onus room ovcr varage N.a. <br /> Dcscribc othcrinsulated arcas�� <br /> Windows & Doors Heating or Cooling Ducts Oufside Conditioned Spaces <br /> Average U-�actor(e.rchrder IS sq.n.,skpligh/s und a�e rtoor)U: ' 3� (�/]Not applicabJe,atl in conditioned space <br /> 5olar Hcat Gain Cocificienr, � 2.g [ ]R= <br /> MECHANICAL SYSTEMS <br /> Make-up Air <br /> Applianees Hentine System Domestic Water Heater Cooling System Select a T��e <br /> Fue1'I��pe � �,, � , [�Not required per mechanical code <br /> �l:mufncturer � p,�" S � �� [ ]Yassive [ ]Pow'ercd <br /> Model ' _r� '3 [ ]Interlocked���ith e�haust device, <br /> 3�� describe <br /> R:�ting or Sire fnpui in B'I'US: ZSOO Capacily in Gallons: S"� Oulput in Tons: ( ]Other,describe: <br /> St�uctu�e'sCulcul�lcd HeatLoss: "'1 —NotApplicable;- HeatGain: � Locationnfductors��stem: <br /> Cfficicncy AFUEorHSPF%: --NotApplicaUle-- SEE2 13 /�[ ,,�_ <br /> Z Calculated cooling load: Cfirr's[-- -] <br /> � Size of Juct[__]inch round <br /> MechanicalVentilationSystem _ oR[__)tn�t�n,ec�i <br /> Descrrbe Any[�dditil�ncd�7�'co+Hbu7e[1 he�fing m•cooling s�•slems if inrtalled.•(e.g.two fiunaces orairsource heat Combustion Air <br /> pump tirith gezs burk-i�p/i�rnace) Selecr a T��e <br /> Select a T��pe [ ]Not required per mechanical code <br /> [�]kIeat Recover Veutilator(HRV) Capacit}�in cFms:Low_�Q/lligh� s� �('f Passive <br /> [ ]Ener�y Recover Ventil,�tor(ERV) Capacity in cfms:Low___/High_ __ [ ]Other,descriUe: <br /> [ j Continuously exhaustina fan(s)rated c3pacity in cfins:__ _ Locntion ofdrrcl ors�stem: <br /> Loc�tion nf 1:m(s)check all that apply:[ ]Master bathroom[ ]Hallway[ ]Otl�er describe: M��� �Bpf�/� <br /> Capacity Cj»r s[__ _] <br /> Continttous vcntiltttion 1':ttc= ___cfin Size ufderct[_�J inch round <br /> Tolal venCilltion(intermittent+continuous)rate= __ __cfin OR[__]inch metal <br /> 42 Builders Association of Minnesora 525 Park St, Sfe 1 SO I St. Paul,MN 55103 800-654-7783 or 651-646-7959 w�nMcbamn.org <br />